Insurance Big Daddy
Ever wondered what would happen if your spouse died and your insurance company refused to pay out? Well, if that were ever to happen, Insurance Big Daddy would be at hand to help you get your money.
Importantly an independent body – the office of the Ombudsman for Long-Term Insurance for South Africa – opened in 1985 to mediate in disputes between long-term policy holders and the Ombudsman’s subscribers. These subscribers are the big assurance companies themselves. An they pay an annual levy and must pay when there are disputes.
How Insurance Big Daddy Works
You may say that there would be a conflict of interest but in fact the Ombudsman staff work independently in terms of a Code of Ethics and Rules.
But complaints do not relate only to unpaid claims. In addition they relate to
- Unsatisfactory policy performance and maturity values
- Bad service
- Lapsing of polices
- Unsatisfactory surrender or paid-up values and
- Partial payment of claims
And the Ombudsman’s large staff handles the following kinds of insurance: life, disability, health, funeral, credit life, credit disability, hospital plan and dread disease.
What the Ombudsman Does Not Do
However the Ombudsman DOES NOT handle complaints relating to financial advice or service from intermediaries, pension and provident funds, preservation funds and retirement annuities, debt review, credit issues, ITC/blacklisting, short-term insurance, banks, labour disputes and medical aid.
Obviously policy holders can only enter into disputes via the Ombudsman with insurance companies who subscribe to the scheme. You can find out if your insurer is a subscriber or not by phoning the customer care line of your insurer, or phone the Ombudsman’s office.
In 2012 alone, the Ombudsman office finalized a massive 4218 disputes. These were distributed roughly proportionately to the size of the various companies. The cases in which policy holders won the disputes involved little-known and small companies.
In 2012, 37.4% of cases were resolved wholly or partially in favour of the policyholder by means of conciliation, mediation, settlement, recommendation or determination. (A determination is where the Ombudsman steps in and makes the final decision. During 2012, Ombudsman had to this in just a single case.)
So this proves that a good way to iron out a problem you may have with your long-term insurer is to contact the Ombudsman’s office. Go to http://www.ombud.co.za/contact-us if you need to contact Insurance Big Daddy!
Next step: Complete and submit the form on this page to get a life insurance quote
All info was correct at time of publishing